Provider Demographics
NPI:1336443852
Name:HILL, KATHRYN (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:HILL
Other - Last Name:LYDECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:3960 KENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1824
Mailing Address - Country:US
Mailing Address - Phone:775-232-4554
Mailing Address - Fax:530-582-6278
Practice Address - Street 1:2810 LAKE FOREST RD.
Practice Address - Street 2:
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145
Practice Address - Country:US
Practice Address - Phone:775-232-4554
Practice Address - Fax:530-582-6278
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-23
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25653106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist